Mike Miliard

(SPONSORED) With value-based care models taking hold, healthcare organizations are under pressure to deliver the best clinical outcomes.

New research found variations in cholesterol levels that drew concern because they could potentially determine whether a physician at point of care would prescribe medication to a patient.

The group seeks permanent waivers for physicians who write 25 or fewer prescriptions per year.

Arguing that too many well-meaning providers are facing financial penalties from meaningful use, the American Hospital Association called on the Centers for Medicare and Medicaid Services this week to offer more flexibility. Specifically, AHA says hospitals that meet 70 percent of meaningful use requirements should be deemed as having complied with the program. With the current "all-or-nothing approach," writes Ashley Thompson, AHA's senior vice president of public policy analysis and development, "failure to meet any one of the requirements under the Medicare and Medicaid EHR Incentive Programs has meant a provider would not receive an incentive payment; more recently, it has meant a provider would be penalized." [Also: Hospitals press HHS on meaningful use] Given the huge complexity and high hurdles of meaningful use, the fact that a hospital missing a given threshold by small amount leads to overall failure is "unfair to providers that make good faith efforts to comply," according the March 22 letter to CMS Acting Principal Deputy Administrator Patrick Conway, MD. CMS has told AHA that it doesn't have the statutory authority to offer anything less than that absolutist approach, according to the letter. But AHA offers a legal analysis that suggests that's not true: "We believe that CMS possesses the authority to eliminate the all-or-nothing approach to meaningful use and that the agency should do so." Among the arguments put forth by CMS for the necessity of an all-in requirement: The law requires more stringent MU measures to improve quality over time; certain measures capture policies, such as health information exchange, that are specifically required by statute; use of a "qualified EHR" must meet all the requirements, not some, in order to meet the law's objectives. The agency has also argued that a more flexible framework wouldn't reduce providers' reporting burden anyway – a contention with which AHA "respectfully disagrees" but points out isn't statutorily binding anyway. "We strongly believe that CMS is not legally required to maintain its  all-or-nothing approach to meaningful use," AHA argues, but instead has "ample legal authority" to adopt a more forgiving approach like the 70 percent threshold it suggests. "This flexibility would support providers who have implemented IT functionality but may not have optimized each function sufficiently to meet the full set of requirements in the EHR Incentive Program in order to avoid a payment adjustment." Twitter: @MikeMiliardHITN Email the writer: mike.miliard@himssmedia.com Like Healthcare IT News on Facebook and LinkedIn

EHR makers including Allscripts, athenahealth, Cerner, drchrono, Epic and McKesson said they will embrace open specs including S4S APIs and FHIR to connect research apps to electronic health records software.  

The National Quality Forum has published its guidance for the new Merit-Based Incentive Payment System. NQF's Measure Applications Partnership examined some five-dozen MIPS performance measures, proposed for implementation in 2017, from which data would be collected to track eligible providers' performance in 2019. "As the U.S. healthcare system increasingly shifts to a performance-based payment system, MAP’s role (is to serve) as an impartial advisor bringing stakeholders together from across the healthcare spectrum," NQF’s chief scientific officer Helen Burstin said in a statement. To that end, MAP offered some suggestions to the U.S. Department of Health and Human Services for better aligning with multiple federal healthcare programs, namely the Medicare Shared Savings Program. [Also: Meaningful use will still be part of MIPS reimbursement, CMS official says] Chief among those was that aligning of measures should be a top priority, and not just for MIPS programs and alternative payment models, but across all federal programs and with states and the private sector where possible. Indeed, NQF found that gaps still exist across clinician-level programs – most notably in patient-centered areas such as patient-reported outcomes, functional status and care coordination. These measures should go beyond patients' experience with the healthcare system to the impact of healthcare on patients' health and well-being. Meanwhile, MAP urged continued exploration of the impact of socioeconomic status and other demographic factors on measure results, noting that the program should be taking into account when providers are caring for high-risk populations. NQF also weighed in on measures for public reporting on CMS' Physician Compare website. With regard to those most useful for consumers and patients, MAP expressed a preference for those focused on care coordination, population health, appropriate care and on outcomes – especially those that are patient-reported. Twitter: @MikeMiliardHITN

(SPONSORED) Hacktivists, ransomware, nation state attacks and espionage, the motivations of cyber security attackers today on healthcare are entirely new and never before imagined.

Medsphere Systems Corp., whose OpenVista electronic health record is based on the architecture of the Department of Veterans Affairs' VistA EHR, has released a mobile version of the technology called Mobile OpenVista Enterprise, or MOVE. With secure and real-time access to patient data wherever a clinician has Wi-Fi or cellular coverage, officials say MOVE – which includes Medsphere's NoteAssist patient documentation system – allows physicians and nurses to review medication orders and record patient information on the go. [Also: OpenVista EHR maker Medsphere merges with MBS/Net] "Without doubt, healthcare IT is moving toward mobility and enhanced, streamlined processes," said Medsphere President and CEO Irv Lichtenwald in a statement. "Medsphere is excited about moving OpenVista in that same direction." On March 17, Medsphere also announced an expansion of it products and services since its recent mergers with Phoenix Health Systems and MBS/Net. Phoenix Health continues to integrate its infrastructure support and application management skills with Medsphere's offerings. Meanwhile, MBS/Net's technology, such as physician practice management system and ambulatory EHR, are being integrated with OpenVista, officials said. Twitter: @MikeMiliardHITN

A new report from the President’s Council of Advisors on Science and Technology claims technologies such as telehealth and wearable sensors should be put to work to help more elderly Americans stay healthy and connected as they age. The report by PCAST, an advisory group of scientists and engineers appointed by President Barack Obama to make policy recommendations related to technology and science, found these types of technologies can help elderly Americans face challenges tied to social connectivity, emotional health and cognitive and physical ability. "With many Americans wishing to live in their homes and communities for as long as possible, technology such as prosthetics, wearable sensors, and other tools for daily living can make that possible," said PCAST members Christine Cassel and Ed Penhoet. [Also: Mobile apps emerging as essential population health tools] As of 2014, an unprecedented 15 percent of the U.S. population was over the age of 65, according to the Census Bureau, and many of them remain active. Recommendations also include creating better access to the Internet as something essential to health, social engagement and well-being, and offering more education and training for seniors in online technologies. PCAST also suggests greater efforts by technology providers to develop monitoring tools for frail and vulnerable elders. But the report also calls on a federal agencies to make changes. Specifically it pointed to telehealth as something with clear benefits for seniors living remotely or with limited mobility – but said the government needed to update regulation and payment policies to reflect recent innovation in the space. For another example, the Federal Trade Commission should continue to enforce regulatory review and guidelines for commercial cognitive training products, PCAST said. [Like Healthcare IT News on Facebook] And the group called upon an array of federal agencies – from the National Institutes of Health to the Defense Advanced Research Projects Agency, or DARPA – to expand research on projects such as robotics and advanced mobility technology. It also recommended that Centers for Medicare and Medicaid Services payment policies should be adapted to increase seniors' access to those next-generation tools. "Technology has played an important role in increasing life expectancy, but it also has an important role to play in increasing the quality of life by maximizing Americans’ ability to function in their later years," PCAST Chairs John Holdren and Eric Lander wrote in a letter to President Obama. Twitter: @MikeMiliardHITN

The I-STOP legislation, first passed in 2012, aims to combat controlled substance abuse. A provision set to take effect at the end of this month requires doctors to prescribe almost everything electronically.